NPIMap

Organization Active NPI

Comfort Care LLC

Doing business as Comfort Care Home Health

  • Home Health Agency
  • Chicago, IL
National Provider Identifier
1801128962
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COMFORT CARE LLC
Doing business as
Comfort Care Home Health
Practice address
8527 S Stony Island Ave
Chicago, IL 60617-2247
Phone
(773) 221-4400
NPI assigned
Feb 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Sandy Wilborn, LPN
Title
Ceo
Phone
(773) 221-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

8527 S Stony Island Ave
Chicago, IL 60617-2247

Mailing address

9427 S Calumet Ave
Chicago, IL 60619-7307
Phone (773) 412-3969

Other names 1

  • Comfort Care Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110330000831 IL Part A Provider - Home Health Agency 7416130380 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801128962. Details of each certification follow.

Home health agency certification: CCN 148295

Legal name
COMFORT CARE LLC
Doing business as
COMFORT CARE HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 20, 2012
Last certification
Jan 20, 2012
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 15, 2010 in IL
Enrollment address
8527 S Stony Island Ave
Chicago, IL 60617-2252

Care Compare: Home health agency

Medicare Care Compare
Listed as
Comfort Care LLCCCN 148295 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jan 20, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

8527 S Stony Island Ave
Chicago, IL 60617
Phone (773) 221-4400

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sandy Wilborn Individual 5% Or Greater Direct Ownership Interest Jan 5, 2011 100%
Corporate Director Jan 5, 2011
W-2 Managing Employee Jan 5, 2011
Dominic Freeman Individual Corporate Director Jan 5, 2011

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1801128962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9427 S CALUMET AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197307",
            "telephone_number": "773-412-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8527 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172247",
            "telephone_number": "773-221-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-01",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "WILBORN",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-221-4400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Care Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.